Mental health care doesn't necessarily extend to presidential candidates, either

If John McCain or Barack Obama were to ever need to seek help from their home states through public mental health services, they wouldn't be pleased. Neither would Joe Biden or Sarah Palin.

So says the National Alliance on Mental Illness, which says that mental health care is an essential part of health care reform."

"It is an issue that every candidate for public office at every level needs to be addressing in this election," said Michael J. Fitzpatrick, executive director of NAMI.

In 2003, the President's New Freedom Commission on Mental Health reported that the nation's public mental health care system is "a system in shambles" in which mental health services are "fragmented, disconnected and often inadequate, frustrating the opportunity for recovery," according to NAMI.

In 2006, NAMI published "Grading the States: A Report on the Nation's Mental Health Care System for Serious Mental Illnesses." In the survey, the national average was D. The home states of the presidential and vice-presidential candidates hardly fared better.

Their scores: Alaska (D); Arizona (D+); Delaware (C-); and Illinois (F).

Mental health advocates say the effects of the Iraq war, as well as the Bush administration's approval of mental health parity as a component of the financial bailout legislation, could provide momentum for the next administration to take mental illnesses as seriously as physical illnesses.

"Mental illness doesn't discriminate between Republicans and Democrats," Fitzpatrick said. "It affects millions of Americans, including veterans of Iraq and Afghanistan, families recovering from natural disasters like Hurricane Katrina, and families confronting home foreclosures or other financial upheavals."

War is hell, but post-traumatic stress is worse

Veterans with mental illness can find ways to escape a life of ruin and despair.

The Substance Abuse and Mental Health Services Administration's Center for Mental Health Services is accepting applications for the Jail Diversion and Trauma Recovery Program's "Priority to Veterans grants."

The purpose of this program is to support expansion of trauma-integrated jail diversion programs to reach the growing number of individuals with post traumatic stress disorder and trauma-related disorders involved in the justice system.

In recognition of the dramatically higher prevalence of trauma related illnesses among veterans, this program will prioritize eligibility for veterans, organizers say. Click here for more information on this grant program, along with the request for applications.

Getting fired by Sarah Palin and landing on your feet

A month ago, I wrote about how I'm one of the few people who know Walt Monegan is without having to read a news story or a Wikipedia entry on Sarah Palin.

Now he's become one of the most talked-about individuals in the 2008 presidential campaign -- and his profile was never bigger than it was on Friday, despite the fact that he's an accomplished and nationally respected trailblazer in the treatment of people with mental illness.

An Alaska ethics inquiry found on Friday that Gov. Palin, the Republican vice presidential candidate, abused her authority by pressuring subordinates -- most notably Monegan, whom Palin appointed to be public safety commissioner -- to fire a state trooper involved in a feud with her family. The finding cast a cloud over John McCain's controversial choice of running mate for the Nov. 4 election, according to Reuters.

For Monegan, however, it was "vindication." "It sounds like they've validated my belief and opinions. And that tells me I'm not totally out in left field,'' Monegan was quoted as saying in an Associated Press story.

But some would argue that it was also long overdue recognition for a man whose prior accomplishments would barely get anything more than a feature story in the Anchorage Daily News.

He's considered a trailblazer in the mental health community because, as chief of the Anchorage Police Department, Monegan and his staff were teaching its officers how to deal with a mental health crisis, and serving as a model for other police departments in the country -- such as Memphis -- who were doing similar things.

I interviewed Monegan for 90 minutes in February 2005 when I was one of six people in the nation who received a Rosalynn Carter Mental Health Journalism Fellowship to write about mental health issues. I chose the judicial treatment of mental health as a topic -- and mental health experts and police departments throughout the country all gave me similar advice.

One after the other, they pointed me in two directions -- Memphis, and Walt Monegan.

I chose Alaska because I was intrigued by this very large, though isolated state that has one of the highest suicide rates in the nation. But it was also way ahead of other states in terms of mental health treatment. The state has mental health courts where the judges act more like counselors than magistrates. A defendant who suffers from schizophrenia can count on getting at least one chance to avoid a hard prison term by getting counseling, taking medication or doing whatever they can to manage their illness.

Then there was Monegan, who was inspired to change the department's approach, he said, because he was tired of watching the same people -- all displaying symptoms of mental disorders -- getting arrested over and over, only to end up back in the streets, untreated.

Some of these people were living in hotels in Anchorage after having walked as much as 100 miles from the state's isolated towns -- where treatment was non-existent -- to get help. Their only other option was to fly because few roads connect Alaska's northern towns with the south. But those plane rides can be anywhere from $500 to $1,000 a piece.

Others were involved in serious crimes -- such as bank robberies and hostage situations -- that Monegan himself responded to. Chances were that Monegan knew them, too, because suspects with a history of mental illness tend to be repeat offenders. They go to jail, where treatment also is non-existent, and find themselves back on the streets once they've served their sentence.

"We've all watched young guys grow up and die, or they end up in jail," said Monegan.

This story was first published in The Huffington Post on Oct. 13, 2008.

Watch for the economic downturn's impact on mental health, too

All the talk about an economic downturn always seems to come down to dollars and cents. But what about its impact on sanity and common sense?

Mental health professionals worry about how the economic downturn and its far-reaching impact on employment, housing and costs of food and gas are affecting many individuals and their families. The resulting financial stress, especially if jobs are lost, can greatly impact mental health by exacerbating an existing condition or giving rise to an illness, such as depression or anxiety, they say.

As a result, the demand for mental health services is increasing, while state and federal resources needed to ensure delivery of these services continue to be insufficient.

Debra Wentz, chief executive officer of the New Jersey Association of Mental Health Agencies Inc., said people who receive mental health treatment "are motivated and able to continue their education and pursue other goals. They are truly inspirational and a profound testament to the value of mental health services,”

“The state and federal governments must provide sufficient funding to ensure that individuals receive needed services and, therefore, have the opportunity to pursue and achieve their goals," she said. "Not only would governmental support enable individuals with mental illnesses to turn their lives around; it would also yield significant savings, which we need, especially in these difficult economic times.”

She said awareness is the first step—not only for individuals who may experience mental illnesses or know others with mental health disorders, but also for political leaders whose support through funding and legislation is vital.

“On a personal level, it is critical to recognize the signs of mental illnesses so that accurate diagnoses and appropriate treatment can be obtained. Like any disease, the sooner mental illnesses are identified, the sooner treatment can begin and the more effective it could be,” Wentz said.

Mental health parity to save financial markets? No kidding...

Some say the Senate financial bailout bill is loaded with pork. But that may be the first time anybody's ever implied that ensuring "mental health parity" is pork.

The Wall Street Journal says that page 310 of the legislation points to the "Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008," an indication that passing the bailout bill will, as a result, also enact legislation that will force insurance companies to treat mental illnesses that same way as physical illnesses.

Though the Senate and the House of Representatives both passed the mental health bill last week, the bailout bill gives the legislation to chance to finally land on the President's desk to be signed into law -- provided the House of Representatives passes it, too, according to The Wall Street Journal.

It also signals the end of a decade-long wait for mental health advocates who have long tried to resurrect and, ultimately, push through Wellstone's legislation after it seemed to nearly disappear following his untimely dealth in 2002.

Many have started blogs, published the names and numbers of lawmakers and lobbied the public heavily to apply pressure on Congress to get the bill passed.

The battle was left up to the states, as a result, to do something on their own - but few grabbed the torch and pushed the effort forward.

At one time, New Jersey was out in front of that effort, but lawmakers had a tough time sealing the deal. The General Assembly in Trenton last year was supposed to post a mental health parity bill in the lame duck session that could finally bring about long-needed equalization of insurance benefits.

It didn't happen, though medical professionals are hopeful that they can help resurrect it.

"Equalization of insurance health benefits to properly cover mental disorders including substance use disorders is right and just," said Joseph Napoli, past president of the New Jersey Psychiatric Association. "It is also cost-effective. The present inadequate coverage for these disorders is penny-wise and dollar-foolish."

People see the impact of these disorders on city streets. Many people who can't afford to get treatment self-medicate by using illegal drugs and alcohol. Their addictions cost them their lives, their families and their homes. Many end up homeless, or in jail.

Napoli is cautiously optimistic that the legislature will finally act. But mental health parity is not a new idea in New Jersey. And every time it's been given a chance to work, something gets in the way that defeats it - or weakens it.

"We can easily count the numerous ways that we all pay dearly because insurance companies refuse to cover these disorders at the same amounts and limits that apply to other disorders," Napoli said. "Insurance companies' costs are greater for general medical conditions complicated by mental disorders."

This article appeared in The Huffington Post on Oct. 3, 2008.